Chimeric antigen receptor

ABSTRACT

The present invention provides a chimeric antigen receptor (CAR) comprising: (i) a B cell maturation antigen (BCMA)-binding domain which comprises at least part of a proliferation-inducing ligand (APRIL); (ii) a spacer domain (iii) a transmembrane domain; and (iv) an intracellular T cell signaling domain. The invention also provides the use of such a T-cell expressing such a CAR in the treatment of plasma-cell mediated diseases, such as multiple myeloma.

FIELD OF THE INVENTION

The present invention relates to chimeric antigen receptor (CAR) whichbinds the B cell maturation antigen (BCMA). T cells expressing such aCAR are useful in the treatment of plasma cell diseases such as multiplemyeloma.

BACKGROUND TO THE INVENTION

Multiple Myeloma

Multiple Myeloma (myeloma) is a bone-marrow malignancy of plasma cells.Collections of abnormal plasma cells accumulate in the bone marrow,where they interfere with the production of normal blood cells. Myelomais the second most common hematological malignancy in the U.S. (afternon-Hodgkin lymphoma), and constitutes 13% of haematologic malignanciesand 1% of all cancers. The disease is burdensome in terms of sufferingas well as medical expenditure since it causes pathological fractures,susceptibility to infection, renal and then bone-marrow failure beforedeath.

Unlike many lymphomas, myeloma is currently incurable. Standardchemotherapy agents used in lymphoma are largely ineffective formyeloma. In addition, since CD20 expression is lost in plasma cells,Rituximab cannot be used against this disease. New agents such asBortezamib and Lenolidomide are partially effective, but fail to lead tolong-lasting remissions.

There is thus a need for alternative agents for the treatment of myelomawhich have increased efficacy and improved long-term effects.

Chimeric Antigen Receptors (CARs)

Chimeric antigen receptors are proteins which, in their usual format,graft the specificity of a monoclonal antibody (mAb) to the effectorfunction of a T-cell. Their usual form is that of a type I transmembranedomain protein with an antigen recognizing amino terminus, a spacer, atransmembrane domain all connected to a compound endodomain whichtransmits T-cell survival and activation signals (see FIG. 3).

The most common form of these molecules use single-chain variablefragments (scFv) derived from monoclonal antibodies to recognize atarget antigen. The scFv is fused via a spacer and a transmembranedomain to a signaling endodomain. Such molecules result in activation ofthe T-cell in response to recognition by the scFv of its target. When Tcells express such a CAR, they recognize and kill target cells thatexpress the target antigen. Several CARs have been developed againsttumour associated antigens, and adoptive transfer approaches using suchCAR-expressing T cells are currently in clinical trial for the treatmentof various cancers. Carpenter et al (2013, Clin Cancer Res 19(8)2048-60) describe a CAR which incorporates a scFv against the B-cellmaturation antigen (BCMA).

BCMA is a transmembrane protein that is preferentially expressed inmature lymphocytes, i.e. memory B cells, plasmablasts and bone marrowplasma cells. BCMA is also expressed on multiple myeloma cells.

Carpenter et al demonstrate that T cells transduced to express theanti-BCMA CAR are capable of specifically killing myeloma cells from aplasmacytoma of a myeloma patient.

Although CAR approaches using anti-BCMA antibodies show promise, aparticular consideration when targeting this antigen is the particularlylow density of BCMA on myeloma cells, in comparison for instance withCD19 on a lymphoma cell. Hence there is a need to increase thesensitivity of target cell recognition of an anti-BCMA CART cell.

DESCRIPTION OF THE FIGURES

FIG. 1—Ligand Specificity and Function Assignment of APRIL and BAFF

B-cell-activating factor (BAFF, TNFSF13B) interacts with BAFF-Receptor(BAFF-R, TNFRSF13C), B-cell membrane antigen (BCMA, TNFRSF17) andtransmembrane activator and calcium modulator and cyclophilin ligandinteractor (TACI, TNFRSF13B) while A proliferation-inducing ligand(APRIL, TNFSF13) interacts with BCMA, TACI and proteoglycans. BAFF-Ractivation affects peripheral B-cell survival, while BCMA may affectplasma cell survival. APRIL interaction with proteoglycans involvesacidic sulphated glycol-saminoglycan side-chain containingamino-terminus of APRIL.

FIG. 2—Expression data of BCMA on Myeloma

Myeloma cells from bone marrow samples from 39 multiple myeloma patientswere isolated by a CD138+ magnetic bead selection. These cells werestained with the anti-BCMA monoclonal antibody J6MO conjugated with PE(GSK). Antigen copy number was quantified using PE Quantibrite beads(Becton Dickenson) as per the manufacturer's instructions. A box andwhiskers plot of antigen copy number is presented along with the range,interquartile and median values plotted. We found the range is348.7-4268.4 BCMA copies per cell with a mean of 1181 and a median of1084.9.

FIG. 3—Standard design of a Chimeric Antigen Receptor

The typical format of a chimeric antigen receptor is shown. These aretype I transmembrane proteins. An ectodomain recognizes antigen. This iscomposed of an antibody derived single-chain variable fragment (scFv)which is attached to a spacer domain. This in turn is connected to atransmembrane domain which acts to anchor the molecule in the membrane.Finally, this is connected to an endodomain which acts to transmitsintracellular signals to the cell. This is composed of one or moresignalling domains.

FIG. 4—Design of the different APRIL-based CARs generated.

The CAR design as shown in FIG. 3 was modified so that the scFv wasreplaced with a modified form of APRIL to act as an antigen bindingdomain: APRIL was truncated so that the proteoglycan bindingamino-terminus is absent. A signal peptide was then attached totruncated APRIL amino-terminus to direct the protein to the cellsurface. Three CARs were generated with this APRIL based binding domain:A. In the first CAR, the human CD8 stalk domain was used as a spacerdomain. B. In the second CAR, the hinge from IgG1 was used as a spacerdomain. C. In the third CAR, the hinge, CH2 and CH3 domains of humanIgG1 modified with the pva/a mutations described by Hombach et al (2010Gene Ther. 17:1206-1213) to reduce Fc Receptor binding was used as aspacer (henceforth referred as Fc-pvaa). In all CARs, these spacers wereconnected to the CD28 transmembrane domain and then to a tripartiteendodomain containing a fusion of the CD28, OX40 and the CD3-Zetaendodomain (Pule et al, Molecular therapy, 2005: Volume 12; Issue 5;Pages 933-41).

FIG. 5—Annotated Amino acid sequence of the above three APRIL-CARS

A: Shows the annotated amino acid sequence of the CD8 stalk APRIL CAR;B: Shows the annotated amino acid sequence of the APRIL IgG1 hinge basedCAR; C: Shows the annotated amino acid sequence of the APRIL Fc-pvaabased CAR.

FIG. 6—Expression and ligand binding of different APRIL based CARs

A. The receptors were co-expressed with a marker gene truncated CD34 ina retroviral gene vector. Expression of the marker gene on transducedcells allows confirmation of transduction. B. T-cells were transducedwith APRIL based CARs with either the CD8 stalk spacer, IgG1 hinge or Fcspacer. To test whether these receptors could be stably expressed on thecell surface, T-cells were then stained withanti-APRIL-biotin/Streptavidin APC and anti-CD34. Flow-cytometricanalysis was performed. APRIL was equally detected on the cell surfacein the three CARs suggesting they are equally stably expressed. C. Next,the capacity of the CARs to recognize TACI and BCMA was determined. Thetransduced T-cells were stained with either recombinant BCMA or TACIfused to mouse IgG2a Fc fusion along with an anti-mouse secondary andanti-CD34. All three receptor formats showed binding to both BCMA andTACI. A surprising finding was that binding to BCMA seemed greater thanto TACI. A further surprising finding was that although all three CARswere equally expressed, the CD8 stalk and IgG1 hinge CARs appearedbetter at recognizing BCMA and TACI than that with the Fc spacer.

FIG. 7—Function of the different Car constructs.

Functional assays were performed of the three different APRIL basedCARs. Normal donor peripheral blood T-cells either non-transduced (NT),or transduced to express the different CARs. Transduction was performedusing equal titer supernatant. These T-cells were then CD56 depleted toremove non-specific NK activity and used as effectors. SupT1 cellseither non-transduced (NT), or transduced to express BCMA or TACI wereused as targets. Data shown is mean and standard deviation from 5independent experiments. A. Specific killing of BCMA and TACI expressingT-cells was determined using Chromium release. B. Interferon-γ releasewas also determined. Targets and effectors were co-cultured at a ratioof 1:1. After 24 hours, Interferon-γ in the supernatant was assayed byELISA. C. Proliferation/survival of CAR T-cells were also determined bycounting number of CAR T-cells in the same co-culture incubated for afurther 6 days. All 3 CARs direct responses against BCMA and TACIexpressing targets. The responses to BCMA were greater than for TACI.

FIG. 8—Killing of primary Myeloma cells by APRIL CAR T-cells

Since most primary myeloma cells express a low number of BCMA moleculeson their surface, it was investigated whether killing of primary myelomacells occurs despite low-density expression. Three cases were selectedwhich represented the range of BCMA expression described in FIG. 2: thefirst had dim expression (lower than mean); the second case hadintermediate expression (approximately mean expression) and the thirdhad bright (above mean expression). A histogram of BCMA staining againstisotype control for all three cases is shown on the left. In this assay,only the CD8 stalk and hinge APRIL CARs were tested. On the left,survival of myeloma cells compared with starting numbers is shown at day3 and day 6 after a 1:1 co-culture of myeloma cells and CAR T-cells. Byday 6, >95% of the myeloma cells were eliminated, including those withdim BCMA expression.

FIG. 9—Vector co-expressing APRIL based CAR with truncated CD34

A cell line expressing the vector used for screening was incubated witheither BCMA-Fc or TACI-Fc and stained with both anti-CD34 andanti-human-Fc PE and FITC conjugated mAbs. The cells were then studiedby flow-cytometery. This shows a typical pattern of binding of BCMA andTACT relative to the marker gene CD34.

FIG. 10A—Schematic diagram illustrating a classical CAR

B: Design of the different APRIL-based CARs generated.

A signal peptide has attached to truncated APRIL amino-terminus. Thiswas fused to different spacers: either the hinge, CH2 and CH3 domains ofhuman IgG1 modified with the pvaa mutation described by Hombach et at(2010 Gene Ther. 17:1206-1213) to reduce Fc Receptor binding; the stalkof human CD8a; and the hinge of IgG1. These spacers were connected to atripartite endodomain containing CD28 transmembrane domain, the OX40endodomain and the CD3-Zeta endodomain.

FIG. 11—Expression of different CARs

The receptors were co-expressed with enhanced blue fluorescence protein2 (eBFP2) using an IRES sequence. Primary human T-cells were transducedand stained with anti-APRIL-biotin/Streptavidin APC. Flow-cytometricanalysis was performed. eBFP2 signal is shown against APRIL detection.All three CARs are stably expressed (representative experiment of 3independent experiments performed using 3 different normal donorT-cells).

FIG. 12—Chromium release assay

Using normal donor peripheral blood T-cells either non-transduced (NT),or transduced to express different spacer CARs as effectors, and SupT1cells either non-transduced (NT), or transduced to express BCMA or TACIas targets. The T-cells were CD56 depleted to reduce NK activity. Thisis a representative of three independent experiments and is shown as anexample. Cumulative killing data is shown in FIG. 7A. Specific killingof BCMA and TACI expressing T-cells is seen with no activity againstnegative target cells.

FIG. 13—Interferon-gamma release

From a 1:1 co-culture of effectors and targets is measured by ELISA. TheCD8 stalk construct appears to have the best specificity while the hingeconstruct results in the most Interferon release demonstrates somenon-specific activity. This is representative of 3 independentexperiments and is shown as an example. Cumulative interferon-gammarelease data is shown in FIG. 7B.

FIG. 14—Examples of BCMA expression on primary myelomas

Four examples of myeloma samples stained with the rat anti-human BCMAmAb Vicky1 is shown. The first panel shows bright BCMA staining in apatient with a plasma cell leukemia (an unusual, advanced and aggressiveform of myeloma). The other three cases are clinically andmorphologically typical myelomas. They show the intermediate or dimstaining typically seen. Staining with isotype control (grey) issuperimposed. These are examples of cumulative BCMA expression datashown in FIG. 2.

FIG. 15—Amino acid sequence of APRIL-CARS with a V5 epitope tag.

A: dAPRIL-HCH2CH3pvaa-CD28OXZ

B: dAPRIL-CD8STK-CD28OXZ

C: dAPRIL-HNG-CD28OXZ

Sequences in this figure differ from those in FIG. 5 have a differentsignal peptide and no V5 tag.

FIG. 16—Demonstration of in vivo function of APRIL CAR T-cells

Six 3 month old female NSG mice received 1×10⁷ MM1.s.FLuc cells vialtail-vein injection. Mice were imaged with bioluminescence at day 8 andday 13. After imaging on day 13, four mice received 5×10⁶ APRIL CART-cells via tail vein injection. Mice were imaged on day 13 and day 18.Mice which received CAR T-cells are indicated with (*). Remission ofMyeloma could be observed by Day 18 in all treated mice, while diseasein untreated mice progressed.

SUMMARY OF ASPECTS OF THE INVENTION

B-cell membrane antigen (BCMA) is a surface protein expressed on nearlyall Multiple Myeloma (MM). BCMA is only otherwise expressed on plasmacells hence targeting this antigen may prove an effective treatment ofmyeloma. However, the low-level expression of BCMA (See FIG. 2), is aconsideration when targeting this antigen.

The present inventors have surprisingly found that if a binding domainis used based on A proliferation-inducing ligand (APRIL), rather than aBCMA-binding antibody, in a CAR-type molecule, T cells expressing suchCARs cause very efficient killing of BCMA-expressing target cells, eventhose with low-levels of expression.

Without wishing to be bound by theory, the present inventors predictthat this is because the three-fold symmetry inherent in the binding ofBCMA with APRIL. This means that every interaction between the CAR andBCMA will involve 3 CARs, approximating 3 endodomains on the T-cellsurface. Since T-cell activation is triggered by close approximation ofsignalling endodomains in an immunological synapse, the CAR design ofthe present invention is highly sensitive and specific. As BCMA isexpressed at a very low density on primary myeloma cells (see FIGS. 2and 7), this receptor design is particularly suited to this target.

Thus, in a first aspect the present invention provides a chimericantigen receptor (CAR) comprising:

(i) a B cell maturation antigen (BCMA)-binding domain which comprises atleast part of a proliferation-inducing ligand (APRIL);

(ii) a spacer domain

(iii) a transmembrane domain; and

(iv) an intracellular T cell signaling domain.

The BCMA-binding domain may comprise a truncated APRIL which comprisesthe BCMA binding site but lacks the amino terminal portion of APRILresponsible for proteoglycan binding. Such a molecule may comprise thesequence shown as SEQ ID No. 14. Alternatively the molecule may comprisea variant of that sequence having at least 80% sequence identity whichbinds BCMA.

The transmembrane and intracellular T-cell signalling domain maycomprise the sequence shown as SEQ ID No. 7 or a variant thereof havingat least 80% sequence identity.

The BCMA-binding domain and the transmembrane domain may be connected bya spacer. The spacer may comprise one of the following: a human IgG1spacer; an IgG1 hinge; or a CD8 stalk.

The CAR of the first aspect of the invention may comprise the sequenceshown as SEQ ID No. 1, 2, 3, 4, 5 or 6 or a variant thereof which has atleast 80% sequence identity but retains the capacity to i) bind BCMA andii) induce T cell signalling.

The CAR of the first aspect of the invention may bind to BCMA as atrimer.

In a second aspect, the present invention provides a nucleic acidsequence which encodes a CAR according to any preceding claim.

The nucleic acid sequence may comprise the sequence shown as SEQ ID No15, 16, 17, 18, 19 or 20 or a variant thereof having at least 80%sequence identity.

In a third aspect, the present invention provides a vector whichcomprises a nucleic acid sequence according to the second aspect of theinvention.

In a fourth aspect, the present invention provides a T cell or an NKcell which expresses a CAR according to the first aspect of theinvention.

In a fifth aspect, the present invention provides a method for making aT cell or an NK cell according to the fourth aspect of the invention,which comprises the step of introducing a nucleic acid according to thesecond aspect of the invention into a T cell or an NK cell.

In a sixth aspect, the present invention provides a pharmaceuticalcomposition which comprises a vector according to the third aspect ofthe invention or T cell/NK cell according to the fourth aspect of theinvention, together with a pharmaceutically acceptable carrier, diluentor excipient.

In a seventh aspect, the present invention provides a method fortreating a plasma cell disorder which comprises the step ofadministering a vector according to the third aspect of the invention orT cell/NK cell according to the fourth aspect of the invention to asubject.

The plasma cell disorder may be selected from plasmacytoma, plasma cellleukemia, multiple myeloma, macroglobulinemia, amyloidosis,Waldenstrom's macroglobulinemia, solitary bone plasmacytoma,extramedullary plasmacytoma, osteosclerotic myeloma, heavy chaindiseases, monoclonal gammopathy of undetermined significance andsmoldering multiple myeloma.

The plasma cell disorder may be multiple myeloma.

In an eighth aspect, the present invention provides a vector accordingto the third aspect of the invention or T cell/NK cell according to thefourth aspect of the invention for use in treating a plasma celldisorder.

In a ninth aspect, the present invention provides use of a vectoraccording to the third aspect of the invention or T cell/NK cellaccording to the fourth aspect of the invention in the manufacture of amedicament for treating a plasma cell disorder.

DETAILED DESCRIPTION

Chimeric Antigen Receptors (CARS)

Chimeric antigen receptors (CARs), also known as chimeric T cellreceptors, artificial T cell receptors and chimeric immunoreceptors, areengineered receptors, which graft an arbitrary specificity onto animmune effector cell. In a classical CAR (FIG. 3), the specificity of amonoclonal antibody is grafted on to a T cell or NK cell. CAR-encodingnucleic acids may be introduced into T cells or NK cells using, forexample, retroviral vectors. In this way, a large number ofcancer-specific T cells or NK cells can be generated for adoptive celltransfer. Early clinical studies of this approach have shown efficacy insome cancers, primarily when targeting the pan-B-cell antigen CD19 totreat B-cell malignancies.

The target-antigen binding domain of a CAR is commonly fused via aspacer and transmembrane domain to a signaling endodomain. When the CARbinds the target-antigen, this results in the transmission of anactivating signal to the T-cell it is expressed on.

The CAR of the present invention comprises:

(i) a B cell maturation antigen (BCMA)-binding domain which comprises atleast part of a proliferation-inducing ligand (APRIL), which isdiscussed in more detail below;

(ii) a spacer

(iii) a transmembrane domain; and

(iv) an intracellular T cell signaling domain

The CAR of the present invention may comprise one of the following aminoacid sequences:

(dAPRIL-HCH2CH3pvaa-CD28OXZ) SEQ ID No. 1METDTLLLWVLLLWVPGSTGSVLHLVPINATSKDDSDVTEVMWQPALRRGRGLQAQGYGVRIQDAGVYLLYSQVLFQDVTFTMGQVVSREGQGRQETLFRCIRSMPSHPDRAYNSCYSAGVFHLHQGDILSVIIPRARAKLNLSPHGTFLGFVKLSGGGSDPAEPKSPDKTHTCPPCPAPPVAGPSVFLFPPKPKDTLMIARTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGKKDPKFWVLVVVGGVLACYSLLVTVAFIIFWVRSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRSRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKIRVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTATKDTYDALHMQALPPR (dAPRIL-CD8STK-CD28OXZ)SEQ ID No. 2METDTLLLWVLLLWVPGSTGSVLHLVPINATSKDDSDVTEVMWQPALRRGRGLQAQGYGVRIQDAGVYLLYSQVLFQDVTFTMGQVVSREGQGRQETLFRCIRSMPSHPDRAYNSCYSAGVFHLHQGDILSVIIPRARAKLNLSPHGTFLGFVKLSGGGSDPTTTPAPRPPTPAPTIASQPLSLRPEACRPAAGGAVHTRGLDFACDIFWVLVVVGGVLACYSLLVTVAFIIFWVRSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRSRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKIRVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTATKDTYDALHMQALPPR (dAPRIL-HNG-CD28OXZ)SEQ ID No. 3METDTLLLWVLLLWVPGSTGSVLHLVPINATSKDDSDVTEVMWQPALRRGRGLQAQGYGVRIQDAGVYLLYSQVLFQDVTFTMGQVVSREGQGRQETLFRCIRSMPSHPDRAYNSCYSAGVFHLHQGDILSVIIPRARAKLNLSPHGTFLGFVKLSGGGSDPAEPKSPDKTHTCPPCPKDPKFWVLVVVGGVLACYSLLVTVAFIIFWVRSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRSRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKIRVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTATKDTYDALHMQALPPR (dAPRIL-HCH2CH3pvaa-CD28OXZ) SEQ ID No. 4MGTSLLCWMALCLLGADHADGKPIPNPLLGLDSTSGGGGSVLHLVPINATSKDDSDVTEVMWQPALRRGRGLQAQGYGVRIQDAGVYLLYSQVLFQDVTFTMGQVVSREGQGRQETLFRCIRSMPSHPDRAYNSCYSAGVEHLHQGDILSVIIPRARAKLNLSPHGTFLGFVKLSGGGSDPAEPKSPDKTHTCPPCPAPPVAGPSVFLFPPKPKDTLMIARTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGKKDPKFWVLVVVGGVLACYSLLVTVAFIIFWVRSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRSRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKIRVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTATKDTYDALHMQAL PPR(dAPRIL-CD8STK-CD28OXZ) SEQ ID No. 5MGTSLLCWMALCLLGADHADGKPIPNPLLGLDSTSGGGGSVLHLVPINATSKDDSDVTEVMWQPALRRGRGLQAQGYGVRIQDAGVYLLYSQVLFQDVTFTMGQVVSREGQGRQETLFRCIRSMPSHPDRAYNSCYSAGVFHLHQGDILSVIIPRARAKLNLSPHGTFLGFVKLSGGGSDPTTTPAPRPPTPAPTIASQPLSLRPEACRPAAGGAVHTRGLDFACDIFWVLVVVGGVLACYSLLVTVAFIIFWVRSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRSRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKIRVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTATKDTYDALHMQALP PR(dAPRIL-HNG-CD28OXZ) SEQ ID No. 6MGTSLLCWMALCLLGADHADGKPIPNPLLGLDSTSGGGGSVLHLVPINATSKDDSDVTEVMWQPALRRGRGLQAQGYGVRIQDAGVYLLYSQVLFQDVTFTMGQVVSREGQGRQETLFRCIRSMPSHPDRAYNSCYSAGVFHLHQGDILSVIIPRARAKLNLSPHGTFLGFVKLSGGGSDPAEPKSPDKTHTCPPCPKDPKFWVLVVVGGVLACYSLLVTVAFIIFWVRSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRSRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKIRVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTATKDTYDALHMQALPPR

The molecule of the invention may comprise a variant of the sequenceshown as SEQ ID No. 1, 2, 3, 4, 5 or 6 having at least 80, 85, 90, 95,98 or 99% sequence identity, provided that the variant sequence is amolecule as defined in the first aspect of the invention, i.e. a CARwhich comprises:

(i) a BCMA-binding domain;

(ii) a spacer domain

(iii) a transmembrane domain; and

(iv) an intracellular T cell signaling domain.

The percentage identity between two polypeptide sequences may be readilydetermined by programs such as BLAST which is freely available athttp://blast.ncbi.nlm.nih.gov.

Transmembrane Domain

The transmembrane domain is the sequence of the CAR that spans themembrane. It may comprise a hydrophobic alpha helix. The transmembranedomain may be derived from CD28, which gives good receptor stability.The transmembrane domain may be derived from any type I transmembraneprotein. The transmembrane domain may be a synthetic sequence predictedto form a hydrophobic helix.

Intracellular T Cell Signaling Domain (Endodomain)

The endodomain is the signal-transmission portion of the CAR. Afterantigen recognition, receptors cluster and a signal is transmitted tothe cell. The most commonly used endodomain component is that ofCD3-zeta which contains 3 ITAMs. This transmits an activation signal tothe T cell after antigen is bound. CD3-zeta may not provide a fullycompetent activation signal and additional co-stimulatory signaling maybe needed. For example, chimeric CD28 and OX40 can be used with CD3-Zetato transmit a proliferative/survival signal, or all three can be usedtogether (Pule et al, Molecular therapy, 2005: Volume 12; Issue 5; Pages933-41). The CAR endodomain may also be derived from other signalingdomains either individually or in combination, derived from signalingproteins found in nature or artificial ones constructed by those skilledin the art such that the CAR transmits a suitable signal to for aneffective CAR therapeutic.

The endodomain of the CAR of the present invention may comprise the CD28endodomain and OX40 and CD3-Zeta endodomain.

The transmembrane and intracellular T-cell signalling domain(endodomain) of the CAR of the present invention may comprise thesequence shown as SEQ ID No. 7 or a variant thereof having at least 80%sequence identity.

SEQ ID No. 7 FWVLVVVGGVLACYSLLVTVAFIIFWVRSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRSRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKIRVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTA TKDTYDALHMQALPPR

A variant sequence may have at least 80%, 85%, 90%, 95%, 98% or 99%sequence identity to SEQ ID No. 7, provided that the sequence providesan effective transmembrane domain and an effective intracellular T cellsignaling domain.

Signal Peptide

The CAR of the present invention may comprise a signal peptide so thatwhen the CAR is expressed inside a cell, such as a T-cell, the nascentprotein is directed to the endoplasmic reticulum and subsequently to thecell surface, where it is expressed.

The core of the signal peptide may contain a long stretch of hydrophobicamino acids that has a tendency to form a single alpha-helix. The signalpeptide may begin with a short positively charged stretch of aminoacids, which helps to enforce proper topology of the polypeptide duringtranslocation. At the end of the signal peptide there is typically astretch of amino acids that is recognized and cleaved by signalpeptidase. Signal peptidase may cleave either during or after completionof translocation to generate a free signal peptide and a mature protein.The free signal peptides are then digested by specific proteases.

The signal peptide may be at the amino terminus of the molecule.

The CAR of the invention may have the general formula:

Signal peptide-BCMA-binding domain spacer domain-transmembranedomain-intracellular T cell signaling domain.

The signal peptide may comprise the SEQ ID No. 8 or 9 or a variantthereof having 5, 4, 3, 2 or 1 amino acid mutations (insertions,substitutions or additions) provided that the signal peptide stillfunctions to cause cell surface expression of the CAR.

SEQ ID No. 8:  MGTSLLCWMALCLLGADHADG SEQ ID No. 9:  METDTLLLWVLLLWVPGSTG

The signal peptide of SEQ ID No. 8 and SEQ ID No 9 is compact and highlyefficient. It is predicted to give about 95% cleavage after the terminalglycine, giving efficient removal by signal peptidase.

Spacer

The CAR of the present invention may comprise a spacer sequence toconnect the BCMA-binding domain with the transmembrane domain andspatially separate the BCMA-binding domain from the endodomain. Aflexible spacer allows to the BCMA-binding domain to orient in differentdirections to enable BCMA binding.

The spacer sequence may, for example, comprise an IgG1 Fc region, anIgG1 hinge or a CD8 stalk. The linker may alternatively comprise analternative linker sequence which has similar length and/or domainspacing properties as an IgG1 Fc region, an IgG1 hinge or a CD8 stalk.

The spacer may be a short spacer, for example a spacer which comprisesless than 100, less than 80, less than 60 or less than 45 amino acids.The spacer may be or comprise an IgG1 hinge or a CD8 stalk or a modifiedversion thereof.

A human IgG1 spacer may be altered to remove Fc binding motifs.

Examples of amino acid sequences for these spacers are given below:

SEQ ID No. 10 (hinge-CH2CH3 of human IgG1)AEPKSPDKTHTCPPCPAPPVAGPSVFLFPPKPKDTLMIARTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGKKD SEQ ID No. 11 (human CD8 stalk):TTTPAPRPPTPAPTIASQPLSLRPEACRPAAGGAVHTRGLDFACDISEQ ID No. 12 (human IgG1 hinge): AEPKSPDKTHTCPPCPKDPKB-Cell Membrane Antigen (BCMA)

The CAR of the first aspect of the invention comprises a domain whichbinds BCMA.

BCMA, also known as TNFRSF17, is a plasma cell specific surface antigenwhich is expressed exclusively on B-lineage haemopoietic cells ordendritic cells. It is a member of the TNF receptor family. BCMA is notexpressed on nave B cells but is up-regulated during B-celldifferentiation into plasmablasts, and is brightly expressed on memory Bcells, plasmablasts and bone marrow plasma cells. BCMA is also expressedon the majority of primary myeloma cells. Unlike other CAR targets suchas CD19, BCMA is expressed at low density (FIG. 2).

BCMA functions within a network of interconnected ligands and receptorswhich is shown schematically in FIG. 1. Two other TNF receptors sharethe ligands APRIL and BAFF with BCMA-TACI (TNFRSF13B), which is found onactivated T-cells and all B-cells and BAFF-R (TNFRSF13C) which ispredominantly expressed on B-lymphocytes. Multiple myeloma cells expressTACI in some cases and BCMA in most cases, but never BAFF-R.

APRIL

The BCMA-binding domain of the CAR of the invention and comprises atleast part of a proliferation-inducing ligand (APRIL). APRIL is alsoknown as TNFSF13.

The wild-type sequence of APRIL is available at UNIPROT/O75888 and isshow below (SEQ ID No. 13). It is not a classical secreted protein inthat it has no signal peptide. It has a furin cleavage site “KQKKQK”(underlined in SEQ ID No. 13). The amino terminus is involved inproteoglycan binding.

The BCMA-binding domain may comprise the BCMA-binding site of APRIL. TheBCMA-binding domain may comprise a fragment of APRIL which comprises theBCMA-binding site.

The BCMA-binding domain may comprise a truncated APRIL, which lacks theamino terminal end of the molecule. The truncated APRIL may retain BCMAand TACI binding but lose proteoglycan binding. Truncated APRIL can becleaved at or immediately after the furin cleavage site. Truncated APRILmay lack the amino terminal 116 amino acids from the wild-type APRILmolecule shown as SEQ ID No. 13. Truncated APRIL may comprise thesequence shown as SEQ ID No. 14 (which corresponds to the portion of SEQID No. 13 shown in bold) or a variant thereof. This corresponds to theportion of the molecule which is needed for BCMA and TACI binding.

SEQ ID No. 13         10         20         30         40    MPASSPFLLA PKGPPGNMGG PVREPALSVA LWLSWGAALG        50         60         70         80AVACAMALLT QQTELQSLRR EVSRLQGTGG PSQNGEGYPW        90        100        110        120QSLPEQSSDA LEAWENGERS RKRRAVLTQ K QKKQH SVLHL       130        140        150        160VPINATSKDD SDVTEVMWQP ALRRGRGLQA QGYGVRIQDA       170        180        190        200GVYLLYSQVL FQDVTFTMGQ VVSREGQGRQ ETLFRCIRSM        210        220        230        240PSHPDRAYNS CYSAGVFHLH QGDILgVIIP RARAKLNLSP        250 HGTFLGFVKLSEQ ID No. 14 VLHLVPINATSKDDSDVTEVMWQPALRRGRGLQAQGYGVRIQDAGVYLLYSQVLFQDVTFTMGQVVSREGQGRQETLFRCIRSMPSHPDRAYNSCYSAGVFHLHQGDILSVIIPRARAKLNLSPHGTFLGFVKL

The CAR of the present invention may comprise a variant of the truncatedAPRIL molecule shown as SEQ ID No. 14 which has at least 80% amino acidsequence identity and which has the same or improved BCMA bindingcapabilities. The variant sequence may have at least 80%, 85%, 90%, 95%,98% or 99% sequence identity to SEQ ID No. 14.

Nucleic Acid Sequence

The second aspect of the invention relates to a nucleic acid sequencewhich codes for a CAR of the first aspect of the invention.

The nucleic acid sequence may be or comprise one of the followingsequences:

(dAPRIL-HCH2CH3pvaa-CD28OXZ) SEQ ID No. 15ATGGAGACCGACACCCTGCTGCTGTGGGTGCTGCTGCTGTGGGTGCCAGGCAGCACCGGCAGCGTGCTCCACCTGGTGCCCATCAACGCCACCAGCAAGGACGACTCTGATGTGACCGAGGTGATGTGGCAGCCAGCCCTGAGACGGGGCAGAGGCCTGCAGGCCCAGGGCTACGGCGTGAGAATCCAGGACGCTGGCGTGTACCTGCTGTACTCCCAGGTGCTGTTCCAGGACGTGACCTTCACAATGGGCCAGGTGGTGAGCCGGGAGGGCCAGGGCAGACAGGAGACCCTGTTCCGGTGCATCCGGAGCATGCCCAGCCACCCCGACAGAGCCTACAACAGCTGCTACAGCGCTGGCGTGTTTCACCTGCACCAGGGCGACATCCTGAGCGTGATCATCCCCAGAGCCAGAGCCAAGCTGAACCTGTCCCCCCACGGCACCTTTCTGGGCTTCGTGAAGCTGTCTGGAGGCGGCTCGGATCCCGCCGAGCCCAAATCTCCTGACAAAACTCACACATGCCCACCGTGCCCAGCACCTCCCGTGGCCGGCCCGTCAGTCTTCCTCTTCCCCCCAAAACCCAAGGACACCCTCATGATCGCCCGGACCCCTGAGGTCACATGCGTGGTGGTGGACGTGAGCCACGAAGACCCTGAGGTCAAGTTCAACTGGTACGTGGACGGCGTGGAGGTGCATAATGCCAAGACAAAGCCGCGGGAGGAGCAGTACAACAGCACGTACCGTGTGGTCAGCGTCCTCACCGTCCTGCACCAGGACTGGCTGAATGGCAAGGAGTACAAGTGCAAGGTCTCCAACAAAGCCCTCCCAGCCCCCATCGAGAAAACCATCTCCAAAGCCAAAGGGCAGCCCCGAGAACCACAGGTGTACACCCTGCCCCCATCCCGGGATGAGCTGACCAAGAACCAGGTCAGCCTGACCTGCCTGGTCAAAGGCTTCTATCCCAGCGACATCGCCGTGGAGTGGGAGAGCAATGGGCAACCGGAGAACAACTACAAGACCACGCCTCCCGTGCTGGACTCCGACGGCTCCTTCTTCCTCTACAGCAAGCTCACCGTGGACAAGAGCAGGTGGCAGCAGGGGAACGTCTTCTCATGCTCCGTGATGCATGAGGCTCTGCACAACCACTACACGCAGAAGAGCCTCTCCCTGTCTCCGGGTAAAAAAGATCCCAAATTTTGGGTGCTGGTGGTGGTTGGTGGAGTCCTGGCTTGCTATAGCTTGCTAGTAACAGTGGCCTTTATTATTTTCTGGGTGAGGAGTAAGAGGAGCAGGCTCCTGCACAGTGACTACATGAACATGACTCCCCGCCGCCCCGGGCCCACCCGCAAGCATTACCAGCCCTATGCCCCACCACGCGACTTCGCAGCCTATCGCTCCAGGGACCAGAGGCTGCCCCCCGATGCCCACAAGCCCCCTGGGGGAGGCAGTTTCCGGACCCCCATCCAAGAGGAGCAGGCCGACGCCCACTCCACCCTGGCCAAGATCAGAGTGAAGTTCAGCAGGAGCGCAGACGCCCCCGCGTACCAGCAGGGCCAGAACCAGCTCTATAACGAGCTCAATCTAGGACGAAGAGAGGAGTACGATGTTTTGGACAAGAGACGTGGCCGGGACCCTGAGATGGGGGGAAAGCCGAGAAGGAAGAACCCTCAGGAAGGCCTGTACAATGAACTGCAGAAAGATAAGATGGCGGAGGCCTACAGTGAGATTGGGATGAAAGGCGAGCGCCGGAGGGGCAAGGGGCACGATGGCCTTTACCAGGGTCTCAGTACAGCCACCAAGGACACCTACGACGCCCTTCACATGCAGGCCCTGCCTCCTCGCTAA (dAPRIL-CD8STK-CD28OXZ) SEQ ID No. 16ATGGAGACCGACACCCTGCTGCTGTGGGTGCTGCTGCTGTGGGTGCCAGGCAGCACCGGCAGCGTGCTCCACCTGGTGCCCATCAACGCCACCAGCAAGGACGACTCTGATGTGACCGAGGTGATGTGGCAGCCAGCCCTGAGACGGGGCAGAGGCCTGCAGGCCCAGGGCTACGGCGTGAGAATCCAGGACGCTGGCGTGTACCTGCTGTACTCCCAGGTGCTGTTCCAGGACGTGACCTTCACAATGGGCCAGGTGGTGAGCCGGGAGGGCCAGGGCAGACAGGAGACCCTGTTCCGGTGCATCCGGAGCATGCCCAGCCACCCCGACAGAGCCTACAACAGCTGCTACAGCGCTGGCGTGTTTCACCTGCACCAGGGCGACATCCTGAGCGTGATCATCCCCAGAGCCAGAGCCAAGCTGAACCTGTCCCCCCACGGCACCTTTCTGGGCTTCGTGAAGCTGTCTGGAGGCGGCTCGGATCCCACCACGACGCCAGCGCCGCGACCACCAACACCGGCGCCCACCATCGCGTCGCAGCCCCTGTCCCTGCGCCCAGAGGCGTGCCGGCCAGCGGCGGGGGGCGCAGTGCACACGAGGGGGCTGGACTTCGCCTGTGATATCTTTTGGGTGCTGGTGGTGGTTGGTGGAGTCCTGGCTTGCTATAGCTTGCTAGTAACAGTGGCCTTTATTATTTTCTGGGTGAGGAGTAAGAGGAGCAGGCTCCTGCACAGTGACTACATGAACATGACTCCCCGCCGCCCCGGGCCCACCCGCAAGCATTACCAGCCCTATGCCCCACCACGCGACTTCGCAGCCTATCGCTCCAGGGACCAGAGGCTGCCCCCCGATGCCCACAAGCCCCCTGGGGGAGGCAGTTTCCGGACCCCCATCCAAGAGGAGCAGGCCGACGCCCACTCCACCCTGGCCAAGATCAGAGTGAAGTTCAGCAGGAGCGCAGACGCCCCCGCGTACCAGCAGGGCCAGAACCAGCTCTATAACGAGCTCAATCTAGGACGAAGAGAGGAGTACGATGTTTTGGACAAGAGACGTGGCCGGGACCCTGAGATGGGGGGAAAGCCGAGAAGGAAGAACCCTCAGGAAGGCCTGTACAATGAACTGCAGAAAGATAAGATGGCGGAGGCCTACAGTGAGATTGGGATGAAAGGCGAGCGCCGGAGGGGCAAGGGGCACGATGGCCTTTACCAGGGTCTCAGTACAGCCACCAAGGACACCTACGACGCCCTTCACATGCAGGCCCTGCCTCCTCGCTAA (dAPRIL-HNG-CD28OXZ) SEQ ID No. 17ATGGAGACCGACACCCTGCTGCTGTGGGTGCTGCTGCTGTGGGTGCCAGGCAGCACCGGCAGCGTGCTCCACCTGGTGCCCATCAACGCCACCAGCAAGGACGACTCTGATGTGACCGAGGTGATGTGGCAGCCAGCCCTGAGACGGGGCAGAGGCCTGCAGGCCCAGGGCTACGGCGTGAGAATCCAGGACGCTGGCGTGTACCTGCTGTACTCCCAGGTGCTGTTCCAGGACGTGACCTTCACAATGGGCCAGGTGGTGAGCCGGGAGGGCCAGGGCAGACAGGAGACCCTGTTCCGGTGCATCCGGAGCATGCCCAGCCACCCCGACAGAGCCTACAACAGCTGCTACAGCGCTGGCGTGTTTCACCTGCACCAGGGCGACATCCTGAGCGTGATCATCCCCAGAGCCAGAGCCAAGCTGAACCTGTCCCCCCACGGCACCTTTCTGGGCTTCGTGAAGCTGTCTGGAGGCGGCTCGGATCCCGCCGAGCCCAAATCTCCTGACAAAACTCACACATGCCCACCGTGCCCAAAAGATCCCAAATTTTGGGTGCTGGTGGTGGTTGGTGGAGTCCTGGCTTGCTATAGCTTGCTAGTAACAGTGGCCTTTATTATTTTCTGGGTGAGGAGTAAGAGGAGCAGGCTCCTGCACAGTGACTACATGAACATGACTCCCCGCCGCCCCGGGCCCACCCGCAAGCATTACCAGCCCTATGCCCCACCACGCGACTTCGCAGCCTATCGCTCCAGGGACCAGAGGCTGCCCCCCGATGCCCACAAGCCCCCTGGGGGAGGCAGTTTCCGGACCCCCATCCAAGAGGAGCAGGCCGACGCCCACTCCACCCTGGCCAAGATCAGAGTGAAGTTCAGCAGGAGCGCAGACGCCCCCGCGTACCAGCAGGGCCAGAACCAGCTCTATAACGAGCTCAATCTAGGACGAAGAGAGGAGTACGATGTTTTGGACAAGAGACGTGGCCGGGACCCTGAGATGGGGGGAAAGCCGAGAAGGAAGAACCCTCAGGAAGGCCTGTACAATGAACTGCAGAAAGATAAGATGGCGGAGGCCTACAGTGAGATTGGGATGAAAGGCGAGCGCCGGAGGGGCAAGGGGCACGATGGCCTTTACCAGGGTCTCAGTACAGCCACCAAGGACACCTACGACGCCCTTCACATGCAGGCCCTGCCTCCTCGCTAA(dAPRIL-HCH2CH3pvaa-CD28OXZ) SEQ ID No. 18ATGGGCACCTCCCTGCTGTGCTGGATGGCCCTGTGCCTGCTGGGAGCCGACCACGCCGACGGCAAGCCCATTCCCAACCCCCTGOTGGGCCTGGACTCCACCTCTGGCGGAGGCGGCAGCGTGOTGCACCTGGTGCCCATCAACGCCACCAGCAAGGACGACTCTGATGTGACCGAGGTGATGTGGCAGCCAGCCCTGAGACGGGGCAGAGGCCTGCAGGCCCAGGGCTACGGCGTGAGAATCCAGGACGCTGGCGTGTACCTGOTGTACTCCCAGGTGCTGTTCCAGGACGTGACCTTCACAATGGGCCAGGIGGTGAGCCGGGAGGGCCAGGGCAGACAGGAGACCCTGTTCCGGTGCATCCGGAGCATGCCCAGCCACCCCGACAGAGCCTACAACAGCTGCTACAGCGCTGGCGTGTTTCACCTGCACCAGGGCGACATCCTGAGCGTGATCATCCCCAGAGCCAGAGCCAAGCTGAACCTGTCCCCCCACGGCACCTTTCTGGGCTTCGTGAAGCTGTCTGGAGGCGGCTCGGATCCCGCCGAGCCCAAATCTCCTGACAAAACTCACACATGCCCACCGTGCCCAGCACCTCCCGTGGCCGGCCCGTCAGTCTTCCTCTTCCCCCCAAAACCCAAGGACACCCTCATGATCGCCCGGACCCCTGAGGTCACATGCGTGGTGGTGGACGTGAGCCACGAAGACCCTGAGGTCAAGTTCAACTGGTACGTGGACGGCGTGGAGGTGCATAATGCCAAGACAAAGCCGCGGGAGGAGCAGTACAACAGCACGTACCGTGTGGTCAGCGTCCTCACCGTCCTGCACCAGGACTGGCTGAATGGCAAGGAGTACAAGTGCAAGGTCTCCAACAAAGCCCTCCCAGCCCCCATCGAGAAAACCATCTCCAAAGCCAAAGGGCAGCCCCGAGAACCACAGGTGTACACCCTGCCCCCATCCCGGGATGAGCTGACCAAGAACCAGGTCAGCCTGACCTGCCTGGTCAAAGGCTTCTATCCCAGCGACATCGCCGTGGAGTGGGAGAGCAATGGGCAACCGGAGAACAACTACAAGACCACGCCTCCCGTGCTGGACTCCGACGGCTCCTTCTTCCTCTACAGCAAGCTCACCGTGGACAAGAGCAGGTGGCAGCAGGGGAACGTCTTCTCATGCTCCGTGATGCATGAGGCTCTGCACAACCACTACACGCAGAAGAGCCTCTCCCTGTCTCCGGGTAAAAAAGATCCCAAATTTTGGGTGCTGGTGGTGGTTGGTGGAGTCCTGGCTTGCTATAGCTTGCTAGTAACAGTGGCCTTTATTATTTTCTGGGTGAGGAGTAAGAGGAGCAGGCTCCTGCACAGTGACTACATGAACATGACTCCCCGCCGCCCCGGGCCCACCCGCAAGCATTACCAGCCCTATGCCCCACCACGCGACTTCGCAGCCTATCGCTCCAGGGACCAGAGGCTGCCCCCCGATGCCCACAAGCCCCCTGGGGGAGGCAGTTTCCGGACCCCCATCCAAGAGGAGCAGGCCGACGCCCACTCCACCCTGGCCAAGATCAGAGTGAAGTTCAGCAGGAGCGCAGACGCCCCCGCGTACCAGCAGGGCCAGAACCAGCTCTATAACGAGCTCAATCTAGGACGAAGAGAGGAGTACGATGTTTTGGACAAGAGACGTGGCCGGGACCCTGAGATGGGGGGAAAGCCGAGAAGGAAGAACCCTCAGGAAGGCCTGTACAATGAACTGCAGAAAGATAAGATGGCGGAGGCCTACAGTGAGATTGGGATGAAAGGCGAGCGCCGGAGGGGCAAGGGGCACGATGGCOTTTACCAGGGTCTCAGTACAGCCACCAAGGACACCTACGACGCCCTTCACATGCAGGCCCTGCCTCCTCGCTAA (dAPRIL-CD8STK-CD28OXZ) SEQ ID No. 19ATGGGCACCTCCCTGCTGTGCTGGATGGCCCTGTGCCTGCTGGGAGCCGACCACGCCGACGGCAAGCCCATTCCCAACCCCCTGCTGGGCCTGGACTCCACCTCTGGCGGAGGCGGCAGCGTGCTGCACCTGGTGCCCATCAACGCCACCAGCAAGGACGACTCTGATGTGACCGAGGTGATGTGGCAGCCAGCCCTGAGACGGGGCAGAGGCCTGCAGGCCCAGGGCTACGGCGTGAGAATCCAGGACGCTGGCGTGTACCTGCTGTACTCCCAGGTGCTGTTCCAGGACGTGACCTTCACAATGGGCCAGGTGGTGAGCCGGGAGGGCCAGGGCAGACAGGAGACCCTGTTCCGGTGCATCCGGAGCATGCCCAGCCACCCCGACAGAGCCTACAACAGCTGCTACAGCGCTGGCGTGTTTCACCTGCACCAGGGCGACATCCTGAGCGTGATCATCCCCAGAGCCAGAGCCAAGCTGAACCTGTCCCCCCACGGCACCTTTCTGGGCTTCGTGAAGCTGTCTGGAGGCGGCTCGGATCCCACCACGACGCCAGCGCCGCGACCACCAACACCGGCGCCCACCATCGCGTCGCAGCCCCTGTCCCTGCGCCCAGAGGCGTGCCGGCCAGCGGCGGGGGGCGCAGTGCACACGAGGGGGCTGGACTTCGCCTGTGATATCTTTTGGGTGCTGGTGGTGGTTGGTGGAGTCCTGGCTTGCTATAGCTTGCTAGTAACAGTGGCCTTTATTATTTTCTGGGTGAGGAGTAAGAGGAGCAGGCTCCTGCACAGTGACTACATGAACATGACTCCCCGCCGCCCCGGGCCCACCCGCAAGCATTACCAGCCCTATGCCCCACCACGCGACTTCGCAGCCTATCGCTCCAGGGACCAGAGGCTGCCCCCCGATGCCCACAAGCCCCCTGGGGGAGGCAGTTTCCGGACCCCCATCCAAGAGGAGCAGGCCGACGCCCACTCCACCCTGGCCAAGATCAGAGTGAAGTTCAGCAGGAGCGCAGACGCCCCCGCGTACCAGCAGGGCCAGAACCAGCTCTATAACGAGCTCAATCTAGGACGAAGAGAGGAGTACGATGTTTTGGACAAGAGACGTGGCCGGGACCCTGAGATGGGGGGAAAGCCGAGAAGGAAGAACCCTCAGGAAGGCCTGTACAATGAACTGCAGAAAGATAAGATGGCGGAGGCCTACAGTGAGATTGGGATGAAAGGCGAGCGCCGGAGGGGCAAGGGGCACGATGGCCTTTACCAGGGTCTCAGTACAGCCACCAAGGACACCTACGACGCCCTTCACATGCAGGCCCTGCCTCCTCGCTAA (dAPRIL-HNG-CD28OXZ) SEQ ID No. 20ATGGGCACCTCCCTGCTGTGCTGGATGGCCCTGTGCCTGCTGGGAGCCGACCACGCCGACGGCAAGCCCATTCCCAACCCCCTGCTGGGCCTGGACTCCACCTCTGGCGGAGGCGGCAGCGTGCTGCACCTGGTGCCCATCAACGCCACCAGCAAGGACGACTCTGATGTGACCGAGGTGATGTGGCAGCCAGCCCTGAGACGGGGCAGAGGCCTGCAGGCCCAGGGCTACGGCGTGAGAATCCAGGACGCTGGCGTGTACCTGCTGTACTCCCAGGTGCTGTTCCAGGACGTGACCTTCACAATGGGCCAGGTGGTGAGCCGGGAGGGCCAGGGCAGACAGGAGACCCTGTTCCGGTGCATCCGGAGCATGCCCAGCCACCCCGACAGAGCCTACAACAGCTGCTACAGCGCTGGCGTGTTTCACCTGCACCAGGGCGACATCCTGAGCGTGATCATCCCCAGAGCCAGAGCCAAGCTGAACCTGTCCCCCCACGGCACCTTTCTGGGCTTCGTGAAGCTGTCTGGAGGCGGCTCGGATCCCGCCGAGCCCAAATCTCCTGACAAAACTCACACATGCCCACCGTGCCCAAAAGATCCCAAATTTTGGGTGCTGGTGGTGGTTGGTGGAGTCCTGGCTTGCTATAGCTTGCTAGTAACAGTGGCCTTTATTATTTTCTGGGTGAGGAGTAAGAGGAGCAGGCTCCTGCACAGTGACTACATGAACATGACTCCCCGCCGCCCCGGGCCCACCCGCAAGCATTACCAGCCCTATGCCCCACCACGCGACTTCGCAGCCTATCGCTCCAGGGACCAGAGGCTGCCCCCCGATGCCCACAAGCCCCCTGGGGGAGGCAGTTTCCGGACCCCCATCCAAGAGGAGCAGGCCGACGCCCACTCCACCCTGGCCAAGATCAGAGTGAAGTTCAGCAGGAGCGCAGACGCCCCCGCGTACCAGCAGGGCCAGAACCAGCTCTATAACGAGCTCAATCTAGGACGAAGAGAGGAGTACGATGTTTTGGACAAGAGACGTGGCCGGGACCCTGAGATGGGGGGAAAGCCGAGAAGGAAGAACCCTCAGGAAGGCCTGTACAATGAACTGCAGAAAGATAAGATGGCGGAGGCCTACAGTGAGATTGGGATGAAAGGCGAGCGCCGGAGGGGCAAGGGGCACGATGGCCTTTACCAGGGTCTCAGTACAGCCACCAAGGACACCTACGACGCCCTTCACATGCAGGCCCTGCCTCCTCGCTAA

The nucleic acid sequence may encode the same amino acid sequence asthat encoded by SEQ ID No. 15, 16, 17, 18 19 or 20 but may have adifferent nucleic acid sequence, due to the degeneracy of the geneticcode. The nucleic acid sequence may have at least 80, 85, 90, 95, 98 or99% identity to the sequence shown as SEQ ID No. 15, 16, 17, 18 19 or 20provided that it encodes a CAR as defined in the first aspect of theinvention.

Vector

The present invention also provides a vector which comprises a nucleicacid sequence according to the present invention. Such a vector may beused to introduce the nucleic acid sequence into a host cell so that itexpresses and produces a molecule according to the first aspect of theinvention.

The vector may, for example, be a plasmid or synthetic mRNA or a viralvector, such as a retroviral vector or a lentiviral vector.

The vector may be capable of transfecting or transducing an effectorcell.

Host Cell

The invention also provides a host cell which comprises a nucleic acidaccording to the invention. The host cell may be capable of expressing aCAR according to the first aspect of the invention.

The host cell may be human T cell or a human NK cell.

A T-cell capable of expressing a CAR according to the invention may bemade by transducing or transfecting a T cell with CAR-encoding nucleicacid.

The T-cell may be an ex vivo T cell. The T cell may be from a peripheralblood mononuclear cell (PBMC) sample. T cells may be activated and/orexpanded prior to being transduced with CAR-encoding nucleic acid, forexample by treatment with a anti-CD3 monoclonal antibody.

Pharmaceutical Composition

The present invention also relates to a pharmaceutical compositioncontaining a vector or a CAR-expressing T cell of the invention togetherwith a pharmaceutically acceptable carrier, diluent or excipient, andoptionally one or more further pharmaceutically active polypeptidesand/or compounds. Such a formulation may, for example, be in a formsuitable for intravenous infusion).

Method of Treatment

T cells expressing a CAR molecule of the present invention are capableof killing cancer cells, such as multiple myeloma cells. CAR-expressingT cells may either be created ex vivo either from a patient's ownperipheral blood (1^(st) party), or in the setting of a haematopoieticstem cell transplant from donor peripheral blood (2^(nd) party), orperipheral blood from an unconnected donor (3^(rd) party).Alternatively, CAR T-cells may be derived from ex-vivo differentiationof inducible progenitor cells or embryonic progenitor cells to T-cells.In these instances, CAR T-cells are generated by introducing DNA or RNAcoding for the CAR by one of many means including transduction with aviral vector, transfection with DNA or RNA.

T cells expressing a CAR molecule of the present invention may be usedfor the treatment of a cancerous disease, in particular a plasma celldisorder or a B cell disorder which correlates with enhanced BCMAexpression.

Plasma cell disorders include plasmacytoma, plasma cell leukemia,multiple myeloma, macroglobulinemia, amyloidosis, Waldenstrom'smacroglobulinemia, solitary bone plasmacytoma, extramedullaryplasmacytoma, osteosclerotic myeloma (POEMS Syndrome) and heavy chaindiseases as well as the clinically unclear monoclonal gammopathy ofundetermined significance/smoldering multiple myeloma.

The disease may be multiple myeloma.

Examples for B cell disorders which correlate with elevated BCMAexpression levels are CLL (chronic lymphocytic leukemia) andnon-Hodgkins lymphoma (NHL). The bispecific binding agents of theinvention may also be used in the therapy of autoimmune diseases likeSystemic Lupus Erythematosus (SLE), multiple sclerosis (MS) andrheumatoid arthritis (RA).

The method of the present invention may be for treating a cancerousdisease, in particular a plasma cell disorder or a B cell disorder whichcorrelates with enhanced BCMA expression.

A method for the treatment of disease relates to the therapeutic use ofa vector or T cell of the invention. In this respect, the vector or Tcell may be administered to a subject having an existing disease orcondition in order to lessen, reduce or improve at least one symptomassociated with the disease and/or to slow down, reduce or block theprogression of the disease. The method of the invention may cause orpromote T-cell mediated killing of BCMA-expressing cells, such as plasmacells.

The invention will now be further described by way of Examples, whichare meant to serve to assist one of ordinary skill in the art incarrying out the invention and are not intended in any way to limit thescope of the invention.

EXAMPLES Example 1—Characterisation of BCMA as a Target for Myeloma

Primary myeloma cells were isolated by performing a CD138 immunomagneticselection on fresh bone marrow samples from Multiple myeloma patientsthat were known to have frank disease. These cells were stained with theBCMA specific J6MO mAb (GSK) which was conjugated to PE. At the sametime, a standard of beads with known numbers of binding sites wasgenerated using the PE Quantibrite bead kit (Becton Dickenson) as perthe manufacturer's instructions. The BCMA copy number on myeloma cellscould be derived by correlating the mean-fluorescent intensity from themyeloma cells with the standard curve derived from the beads. It wasfound that the range of BCMA copy number on a myeloma cell surface islow: at 348.7-4268.4 BCMA copies per cell with a mean of 1181 and amedian of 1084.9 (FIG. 2). This is considerably lower than e.g. CD19 andGD2, classic targets for CARs. Presence of BCMA expression on primarymyeloma cells was also confirmed with the Vicky-1 antibody (AbcamAb17323), examples of which are shown in FIG. 14.

Example 2—Design and Construction of APRIL Based CARs

APRIL in its natural form is a secreted type II protein. The use ofAPRIL as a BCMA binding domain for a CAR requires conversion of thistype II secreted protein to a type I membrane bound protein and for thisprotein to be stable and to retain binding to BCMA in this form. Togenerate candidate molecules, the extreme amino-terminus of APRIL wasdeleted to remove binding to proteoglycans. Next, a signal peptide wasadded to direct the nascent protein to the endoplasmic reticulum andhence the cell surface. Also, because the nature of spacer used canalter the function of a CAR, three different spacer domains were tested:an APRIL based CAR was generated comprising (i) a human IgG1 spaceraltered to remove Fc binding motifs; (ii) a CD8 stalk; and (iii) theIgG1 hinge alone (cartoon in FIG. 4 and amino acid sequences in FIG. 5,and also amino acid sequences in FIG. 19 which differ from the sequencesin FIG. 5 by having a different signal peptide and the V5 epitope tag).These CARs were expressed in a bicistronic retroviral vector (FIG. 6A)so that a marker protein-truncated CD34 could be co-expressed as aconvenient marker gene.

Example 3—Expression and Function of APRIL Based CARs

The aim of this study was to test whether the APRIL based CARs which hadbeen constructed were expressed on the cell surface and whether APRILhad folded to form the native protein. T-cells were transduced withthese different CAR constructs and stained using a commerciallyavailable anti-APRIL mAb, along with staining for the marker gene andanalysed by flow-cytometry. The results of this experiment are shown inFIG. 6B where APRIL binding is plotting against marker genefluorescence. These data show that in this format, the APRIL based CARsare expressed on the cell surface and APRIL folds sufficiently to berecognized by an anti-APRIL mAb.

Next, it was determined whether APRIL in this format could recognizeBCMA and TACI. Recombinant BCMA and TACI were generated as fusions withmouse IgG2a-Fc. These recombinant proteins were incubated with thetransduced T-cells. After this, the cells were washed and stained withan anti-mouse fluorophore conjugated antibody and an antibody to detectthe marker gene conjugated to a different fluorophore. The cells wereanalysed by flow cytometry and the results are presented in FIG. 6C. Thedifferent CARs were able to bind both BCMA and TACI. Surprisingly, theCARs were better able to bind BCMA than TACI. Also, surprisingly CARswith a CD8 stalk or IgG1 hinge spacer were better able to bind BCMA andTACI than CAR with an Fc spacer.

Example 4—APRIL Based Chimeric Antigen Receptors are Active Against BCMAExpressing Cells

T-cells from normal donors were transduced with the different APRIL CARsand tested against SupT1 cells either wild-type, or engineered toexpress BCMA and TACI. Several different assays were used to determinefunction. A classical chromium release assay was performed. Here, thetarget cells (the SupT1 cells) were labelled with ⁵¹Cr and mixed witheffectors (the transduced T-cells) at different ratio. Lysis of targetcells was determined by counting ⁵¹Cr in the co-culture supernatant(FIG. 6A shows the cumulative data, example data from a single assaywith different effector:target ratios is shown in FIG. 12).

In addition, supernatant from T-cells cultured 1:1 with SupT1 cells wasassayed by ELISA for Interferon-gamma (FIG. 6B shows cumulative data,example data from a single assay is shown in FIG. 13). Measurement ofT-cell expansion after one week of co-culture with SupT1 cells was alsoperformed (FIG. 6C). T-cells were counted by flow-cytometry calibratedwith counting beads. These experimental data show that APRIL based CARscan kill BCMA expressing targets. Further, these data show that CARsbased on the CD8 stalk or IgG1 hinge performed better than the Fc-pvaabased CAR.

Example 5—APRIL Based CARs are Able to Kill Primary Myeloma Cells

The above data are encouraging since they demonstrate that it inprinciple, it is possible to make an APRIL based CAR. However, sincemost primary myeloma cells express a low number of BCMA molecules ontheir surface, it was investigated whether such an APRIL based CAR wouldcause killing of primary myeloma cells, particularly in cases withlow-density expression. Three cases were selected which represented therange of BCMA expression described in FIG. 2: the first had dimexpression (lower than mean); the second case had intermediateexpression (approximately mean expression) and the third had bright(above mean expression). FIG. 8 shows a histogram of BCMA stainingagainst isotype control for all three cases on the left to illustrateBCMA expression. Since when comparing APRIL based CARs with differentspacers it had been determined that CARs with CD8 stalk spacer and IgG1hinge spacer performed better than the Fc-pvaa spacered CAR, in thisassay, only the CD8 stalk and hinge APRIL CARs were tested. On the left,survival of myeloma cells compared with starting numbers is shown at day3 and day 6 after a 1:1 co-culture of myeloma cells and CAR T-cells. Byday 6, >95% of the myeloma cells were eliminated, including those withdim BCMA expression. Dim BCMA expressing myeloma cells can be targetedby the APRIL CARs albeit with a slower tempo of killing than higherexpressers.

Example 6—Secreted and Truncated APRIL Fused to an Fc Spacer RecognizesBCMA and TACI

In order to investigate whether truncated APRIL in a CAR format (i.e.fused to a transmembrane domain and anchored to a cell membrane) couldbind BCMA and TACI, a basic CAR was engineered in frame with theself-cleaving foot and mouth disease 2A peptide with truncated CD34, asa convenient marker gene. A stable SUPT1 cell line was established whichexpresses this construct. Secreted truncated BCMA and TACI fused tohuman (and other species, not shown) Ig Fc domain was also generated andrecombinant protein produced. It was shown that both BCMA-Fc and TACI-Fcbind the engineered SUPT1 cell line. Only cells expressing the CD34marker gene were found to bind BCMA-Fc and TACI-Fc (FIG. 9).

Example 7—APRIL Based Chimeric Antigen Receptors are Stably Expressed onthe Surface of T-Cells

The CAR spacer domain can alter sensitivity and specificity. Threeversions of an APRIL-based CAR were generated with three spacer domains:(i) a human IgG1 spacer altered to remove Fc binding motifs; (ii) a CD8stalk; and (iii) the IgG1 hinge alone (FIG. 10B). Primary human T-cellswere transduced with these different CARs and stained using acommercially available anti-APRIL mAb (FIG. 11).

Example 8—APRIL Based Chimeric Antigen Receptors are Active AgainstCognate Target Expressing Cells

T-cells from normal donors were transduced with the different APRIL CARsand tested against SupT1 cells either wild-type, or engineered toexpress BCMA and TACI. Several different assays were used to determinefunction. A classical chromium release assay was performed. Here, thetarget cells (the SupT1 cells) were labelled with ⁵¹Cr and mixed witheffectors (the transduced T-cells) at different ratio. Lysis of targetcells was determined by counting ⁵¹Cr in the co-culture supernatant(FIG. 12).

In addition, supernatant from T-cells cultured 1:1 with SupT1 cells wasassayed by ELISA for Interferon-gamma (FIG. 13).

Measurement of T-cell expansion after one week of co-culture with SupT1cells was also performed. T-cells were counted by flow-cytometrycalibrated with counting beads. Initial data (not shown) appears toindicate that the CD8 stalk based construct results in more T-cellproliferation than the other constructs.

Example 9—Demonstration of In Vivo Function of APRIL CAR T-Cells

In order to demonstrate APRIL CAR T-cell function in vivo, APRIL CART-cells were tested in a human/mouse chimeric model. MM1.s (ATCCCRL-2974) is a human myeloma cell line which expresses intermediatelevels of BCMA. The inventors engineered this cell line to expressfirefly Luciferase to derive the cell-line MM1.s.FLuc.

NOD scid gamma (NSG: NOD.Cg-Prkdc^(scid) II2rgtm1^(Wjl/SzJ)) mice areprofoundly immunosuppressed mice capable of engrafting several humancell lines and human peripheral blood lymphocytes. Three month oldfemale NSG mice received 1×10⁷ MM1.s.FLuc cells vial tail-vein injectionwithout any preparative therapy. Engraftment was determined by serialbioluminescence imaging (FIG. 16). Robust and increasing intramedullaryengraftment was observed in all mice. At day 13, 5×10⁶ APRIL-HNG-CD28OXZCAR T-cells were administered via tail vein injection. Serialbioluminescence was performed which showed rapid decrease in burden ofMM1.s (FIG. 16) in all treated mice to a complete remission. Thisresponse to CAR therapy was confirmed by flow-cytometry andimmunohistochemistry.

All publications mentioned in the above specification are hereinincorporated by reference. Various modifications and variations of thedescribed methods and system of the invention will be apparent to thoseskilled in the art without departing from the scope and spirit of theinvention. Although the invention has been described in connection withspecific preferred embodiments, it should be understood that theinvention as claimed should not be unduly limited to such specificembodiments. Indeed, various modifications of the described modes forcarrying out the invention which are obvious to those skilled inmolecular biology, cellular immunology or related fields are intended tobe within the scope of the following claims.

The invention claimed is:
 1. A method for the treatment of plasma cellcancer selected from the group consisting of plasmacytoma, plasma cellleukemia, multiple myeloma, macroglobulinemia, Waldenstrom'smacroglobulinemia, solitary hone plasmacytoma, extramedullaryplasmacytoma, osteosclerotic myeloma, heavy chain diseases, monoclonalgammopathy of undetermined significance and smoldering multiple myelomain a subject, comprising: administering to the subject a T cell whichexpresses a chimeric antigen receptor (CAR), wherein the CAR comprises:a truncated proliferation-inducing ligand (APRIL) that (a) binds B cellmaturation antigen (BCMA) and (b) binds transmembrane activator andcalcium modulator and cyclophilin ligand interactor (TACI) (ii) a spacerdomain, (iii) a transmembrane domain; and (iv) an intracellular Tsignaling domain, wherein administration of said T-cell results in areduction in cancer cells in the subject.
 2. The method according toclaim 1, wherein the truncated APRIL lacks the amino terminal portion ofAPRIL responsible for proteoglycan binding.
 3. The method according toclaim 2, wherein the truncated APRIL comprises the sequence set forth inSEQ ID No.
 4. The method according to claim 1, wherein the transmembraneand intracellular T-cell signalling domain of the CAR comprise thesequence set forth in SEQ ID No.
 7. 5. The method according to claim 1,wherein the spacer domain of the CAR comprises one of the following: ahuman IgG1 spacer; an IgG1 hinge; or a CD8 stalk.
 6. The methodaccording to claim 5, wherein the spacer domain of the CAR comprises aCD8 stalk.
 7. The method according to claim 1, wherein the CAR comprisesthe sequence set forth in SEQ ID No. 1, 2, 3, 4, 5 or
 6. 8. The methodaccording to claim 1, wherein the plasma cell disorder is multiplemyeloma.